Treatment:

The goal of treatment is to suppress the immune response without damaging the new cells. Medicines commonly used include methotrexate, cyclosporine, tacrolimus, sirolimus, ATG, and alemtuzumab either alone or in combination.

High-dose corticosteroids are the most effective treatment for acute GVHD. Antibodies to T cells and other medicines are given to patients who do not respond to steroids.

Treatment of chronic GVHD includes prednisone (a steroid) with or without cyclosporine. Other treatments include mycophenolate mofetil (CellCept), sirolimus (Rapamycin), and tacrolimus (Prograf).

Expectations (prognosis):

How well a person does depends on the severity of the condition. Some cases of GVHD can lead to death.

Many cases, whether acute or chronic, can be treated successfully. Sometimes treatment of the condition can lead to severe complications.

Successful treatment of GVHD does not guarantee that the transplant itself will succeed in treating the original disease.

Complications:

• Cholestasis
• Death
• Moderate to severe damage to the liver, lung, or digestive tract
• Severe infection
• Severe lung disease

Calling your health care provider:

If you have had a bone marrow or stem cell transplant, call your health care provider immediately if any unusual symptoms appear, including:

• Diarrhea
• Difficulty breathing
• Skin rash
• Stomach cramps
• Yellowing of the skin or eyes (jaundice)